Y HQC VigT NAM THANG 7 • s 6 1/2013 cao va gia t3ng theo tuoi, cu the la nhom tuoi
dffdi 10 tuol la 29 % va tff 30 t r d len la 6 1 % [ 6 ] . Ben canh do ket qua trong nghien cffu cung cho thay t } le nff gidi mSc cac benh ly ve rSng mieng cao gap doi nam gidi, ket qua nay phii h(?p vdi nghien cffu ciia tac gia Thoa. C. Nguyen khl nghien cffu ve tinh tr^ng sffc khoe rSng mieng d ngffdi Idn tai khu vffc phia Nam Viet Nam nSm 2010 tren 2965 dol tffdng thi nff gidl mSc benh sau r§ng cao hdn nam gidl [ 5 ] .
Chi phi cho dieu trj tff lau da t r d thanh mpt ganh nSng kinh te cho bat ky quoc gia nao.Theo bao cao ciia WHO nam 1978, My tieu ton 100 trieu gid cong lao dpng, 9 ty USD cho viec dieu tri rSng va 10 USD cho 1 rang d tre em, tai Anh la 180 trieu bang Anh va Phap la 8 ty fiance [4]. Do vay, vdi ket qua khao sat trong nghien ciilj cho thay 89,2 % dffdc bao phii bdi bao hiem y te, dieu nay se giilp cho hp gia dinh giam bdt ganh nang ve chi phi y te nhffng dong thdi cung dat ra van de cho cac nha hoach dinh chi'nh sach trong viec giam bdt ganh nang chi phi y te bang cac hoat dpng can thiep hull hieu hdn ngoai chffdng trinh Nha hpc dffdng dang thffc hien hien nay.
V. KET LUAN
Qua thdi gian khao sat tff thang 1 den thang 12 nam 2012, cd tong so la 6899 trffdng hdp mac benh ly rang mieng tai khoa kham benh vien trffdng Dai hpc Tay Nguyen. Ket qua nhff sau;
- Mo hinh benh ly rang m i f n g nhff sau:
Sau rang la 3 8 % , Nha chu la 3 4 % , viem quanh r3ng la 24 % , benh khac la 3,9%.
- Nff gidi m§c cac benh ly ve rSng mat la 69 % va nam la 6 1 % .
- Nhdm tuol dffdi 10 tuoi la 15,4%, tff 11 den 201^ 26,5%, 31 den 40 la 43,4% va b^n 40 la 14,8%
- Ve phffdng phap dieu t r j : Tram r§ng la 35,4%, nho rSng la 2 6 , 6 % , cao vol rang la 20,6%, dieu trj tiiy la 13,6% va dieu tn khac chiem 3,9%.
Tham gia BHYT la 8 9 , 2 % . T A I L I E U T H A M K H A O
1. Trdn Thj My Hanh ( 2 0 0 6 } . "Nhan xet tinh hlnh sau rdng va viem ldl d hpc sinh Iffa tuoi 7-11 tai Tru'dng Tieu hpc Thanh Uet",Luan vin thac a'Y hgc, Dai hgc YHa Ngi,tr.38.
2. Le Ba NghTa ( 2 0 0 9 ) , "Nghien cffu moi lien quan giu'a kien thffc, thai do, hanh vi chim soc ring mieng va sau rang vmh vien d hpc Sinh 12- 15 tuoi tai tru'dng trung hpc cd sd T i n Mai - Ha Noi". Luan vin Thac sy y hoc. Trddng Dai hoc Y Ha Ngi
->. Vo Thj Kim Quyen ( 2012). "Khao sat b ^ h sau rang va sdc nhai d sinh wen y khoa nam thff nhat, trUdng Dai hpc Tay Nguyen " f ^ ^ / c ^ c f f a J :
<f. Chuc. T. Nguyen et al (2010). "Oral health status of aldults in Southern Viet Nam- a cross sectfonal epidemiology sutdy." Bi^Oiaih^lth, 10,2.
^. Hu. D.Y. et al ( 2011). "Oral health in China - Trends and challenges '^.IntJ Oral, 3 (1), pp 7-12
NGHIEN Ciiu llfNG DUNG PROTEIN TAI TO HOP PHAT HIEN LUU HANH CUA VIRUS CHIKUNGUNYA TREN DjA BAN HA NOI B A N G P H U U N G PHAP ELISA
T 6 M TAT
De ph^t hien lUu hanh ciia virus Chikungunya (CHIKV) bSng phu'Ong phap EUSA, protein tai to hop ciia CHIKV (El, E2 va C) dUpc sff dung phat hi§n khang the IgG cua CHIKV trong huyet tu'ong ciia 158 ngu'di khoe manh song tren dja ban Ha Npi. Ket qua cho thay ti le du'ong tinh vdi IgG ciia CHIKV la 36%
(56/158). Vdl ket qua nay. Ha noi da co tu\j hanh cua CHIKV.
* Hgc vien Quan y
Phan bifn khoa hgc: TS. Hd Anh Son
Hoang Anh TuanS Vu Xuan NghTa*
SUMMARY
TO FIND OUT THE PREVALENCE OF CHIKV BY EUSA ASSAYS IN HANOI To find out the prevalence of CHIKV by EUSA assays, the CHIKV structural proteins (El, E2 and C) were used to screen anti-CHIKV IgG anbbody in the sera of 158 healthy people living in Hanoi. The results revealed that the percentage of positive in Viemamese
Y HQC VigT NAM THAHG 7 - SO 1/2013 sera was up to 36 % (56 out of 158 samples). These
results suggested that CHIKV might circulate in Hanoi.
I.
OAT VANof
De chan doan nhien CHIKV, den nay co nhieu phffdng phap da dddc ffng dung. Trong glai doan dSu nhiem vlnjs, phudng phap phan lap va PCR dffdc utig dung chu yeu. PhuUng phap phan lap la cong cu chan doan truyen thong dffdc thffc hien vdl huyet tffdng ciia benh nhan bj nhiem tii" 3-5 ngay dau. Tuy nhien, phan lap virus dol hdi thdi gian, thffc hien trong dieu kien an toan sinh hpc cap 3.
Phffdng phap PCR cd dp nhay cao va phii hdp cho chan doan sdm (Edw/ards et al., 2007; Laurent et al., 2007). Nhffng ca hai phffdng phap doi hdi phai ttiffc hien tai cac labo trung ^ m y te Idn. Bdi vay, phudng phap chan doan huyet thanh hpc la phffdng phap nhanh, nhay, tien ich nhat phat hien CHIKV lutJ hanh trong cpng dong, phffdng phap nay phat hien ca IgM trong giai doan sdm va IgG sau 2 tuan nhiem (Pialoux et al., 2007), Trong nghien cu\j nay chung toi ffng dung protein tai to hdp ( E l , E2 va C) phat hien sff luff hanh ciia CHIKV d Ha npi bang phffdng phap ELISA.
II. o d l TUpNG VA PHUONG PHAP NGHIEN CClU 2 . 1 . Do! tu'dng nghien cufu
Miu chu'ng du'dng: 28 mau huyet thanh CO IgG ciia CHIKV dffdc phat hien bang phffdng phap m i i n dich huynh quang tff vien Berhard NochtIn5titut"(BNI)-CHLB Bffc.
fifau chuhg am: 100 mau huyet thanh ngffdi khoe manh tff vien virus-mien dich hpc- CHLB Ddc dffdc xac dinh am tinh vdi
CHIKV/DENV bang phffdng phap mien djch huynh quang.
fifyu nghiin cutt: 158 mau huyet biOng n g u ^ khoe manh sdng tren d\a ban thanh pho Ha Npi.
Protein tai to hdp El, £2 va C: Offdc bieu hien tren he E.coli va tinh sach theo phffdng phap bien tinh.
2.2. Phu'dng phdp nghien cu'u Phddng phap dign mau ngau nhien cd chil di'ch, nghien cffu cat ngang va ket hdp labo.
Phddng phap ELISA: Protein dffdc pha bang trong PBSN (Phosphate Buffered Saline Natriumazld) d nong dp 220p^/ml. Cl 50 pi dung djch protein pha loang d moi gieng trong dTa EUSA. Sau do, dTa dffdc phii kin bang tam plastic va il qua dem d 4°C. Ngay hom sau, bo djch u, rffa dTa 3 lan vdi nffdc cat khong ion. Tien hanh bffdc block bang ii vdi 50pl blocking buffer trong 30 phut d nhiet dp phong. Rffa dia 2 lan vdi nffdc cat khong ion. IJ vdi huyet tffdng chulng dudng va khang the khl cho SOpI huyet tffdng chffng dudng vao moi gieng (Huyet tffdng dffdc pha loang trong dung dich blocking buffer ti le 1:100). Che phii vdi tam plastic, ii d nhiet dp phong bong 2 gid. Rite dTa 3 lan vdl nffdc cat khong ion. Them SOpI conjugated anti human second antibody, pha loang d 1:5000 trong dung djch blocking buffer. Che phii dTa vdi tam plastic va il d nhiet do phong trong 2 gid. RuS dia 2 lan vdi nffdc cat khong ion. Cho phu gia va do ket qua bang each Pipet 75pl NPP (p-Nitrophenyl Phosphate) vao moi gieng, ii d nhiet dp phong trong 1 gid. Sau khi phat trie'n mau (mau vang), dia dffdc dpc tren may EUSA d bffdc sdng 405mm.
III. KET QUA VA BAN LUAN
3 . 1 . LTng dung protein tat t o hdp phat hien I g G ciia CHIKV trong nhom chu'ng du'dng Protein tai to hdp ciia CHIKV E l , E2 va C dffdc sff dung trong phffdng phap ELISA gian tiep phat hien IgG trong nhdm chffng dffdng dffdc chan doan bang phffdng phap IFA tff BNI-CHLB Offc. Dffdng b'nh khi gia t n OD40S cao hdn 0,1± 0,01 so vdi chffng am. Ket qua cho thay, 13 mau dffdng tinh vdi E l , 7 mau vdi C va 14 vdi E2 protein (hinh 1)
Hinh J.'Oanh gia khang the IgG ciia CHIKV bang EUSA ciia 28 mau dffdng tinh.
Y HQC VigT NAM THANG 7 • s 6 1/2013 Khi ket hdp ket qua ciia 3 protein tai to hdp
cho thay 20 mau/28 (71,4%) dffdng ti'nh vdi protein cau true ciia CHIKV. Neu ket hdp chi vdi 2 protein cau true ket qua dffdng tinh tff 5 7 - 7 1 % phu thuoc vao viec ket hdp cac protein nao. Khi ket hdp E l vdi E2 hoSc E l vdi C cho ti le dffdng tinh cao hdn so vdi ket hdp E2 vdi C. Trong nhihig protein cau true, E2 cho thay co kha n5ng phat hien cao nhat, dieu nay cho thay E2 cd kha nSng dap iitig sinh khang the tot nhat, nhffng khang the nay cd hieu qua trong trung hoa kha n3nq nhiem ciia virus va bao ve chupt khl gay nhiem virus (Grosfeld et al., 1989). Ngffdc lai, hau het cac khang the ddn dong d3c hieu vdi E l khong co kha nSng bao ve trong ca phffdng phap trung hoa va chong nhiem (Razumov, 1991).
3 . 2 . D'ng d u n g p r o t e i n t a i t d hdp phdt hi^n I g G cua C H I K V d n h 6 n i n g h i e n cC(u
Cac protein tai t o hdp cung dffdc sff dung nhff nhffng khang nguyen phat hien khang the khang CHIKV trong mau ngffdi khoe manh tren dja ban Ha npi. Mpt so cong trinh khoa hoc trffdc day cho thay d nddc ta cung co sff Iffu hanh oia CHIKV. Bdi vay, de phat hi?n sff Iffu hanh cua CHIKV trong cpng <S6ng, 158 mau nghien cffu dffdc thffc hien trong phffdng phap ELISA phat hien IgG cua CHIKV. Ket qua cho thay, 25 mau/158 phan ffng vcfi E l , 26/158 vdi E2 va 6/158 dffdng tinh vdi C. Khi ket hdp cac protein tai to hdp ket qua phat hien IgG tff 20-36,4%
(hinh 2).
Hinh 2: Ti le phat hien IgG ciia CHIKV khi ffng dung cac protein tai to hdp bang phuOng phap ELISA.
Vdi ket qua dffdng ti'nh tdi 3 6 % (56/158 mau) bang phffdng phap ELISA cho thay CHIKV Iffu hanh tren dia ban Ha npi. Hdn nffa, nffdc ta la qudc gia co ti le Iffu hanh djch sot xuat huyet dengue cao (Thai et al. 2005). Ca virus dengue va CHIKV deu dffdc truyen bdi muoi Aedes, muoi pho bien d nu'dc ta, trieu chffng lam sang va can lam sang kha tu'dng dong. Bdi vay, nu'dc ta trong nguy cd cao nhiem virus dengue va CHIKV.
V. KET LUAN
Protein tai to hdp E l , E2 va C dddc dng dyng phat hien IgG ciia CHIKV bdi phffdng phap EUSA. Ket qua cho thay cac protein tai to hdp co kha nang phat hien 3 6 % so mau dffdng ti'nh vdi IgG ciia CHIKV. Dieu nay cho thay co sff liAi hanh ciia CHIKV trong cpng dong tai Ha npi.
TAI UEU T H A M K H A O
1. Edwards CJ., Welch SR. et at. (2007). Molecular diagnosis and analysis of Chikungunya virus. J Clin Virol; 39 (4), 271-5.
Grosfeld H., Velan B., Leitner M., et al., (1989). Semliki Forest virus E2 envelope epitopes induce a nonneutralizing humoral response wliidi protects mice against lethal challenge. J. VimL 63, 3416-3422.
Laurent P,Le Roux K, et aL (2007).
Development of a sensitive real-time reverse transcnptase PCR assay with an internal control to detect and quantify chikungunya virus. Qin Chem.
53(8), 1408-14.
Pialoux G,, Gauzere BA., et aL (2007).
Chikungunya, an epidemic arbovirosis. Lancet Infed Dis. 7, 319-327
Razumov IA., Agapov EVv et aL (1991). Study of the antigenic structure of the El gtycoprtitein of flie Venezuelan equine encephatomyelihs virus uang monoclonal antibodies, MolGeni^i/aotxoimjsoi.6,2M.
Suranjith L.Seneviratne, MRCP, Padmalal Gurugama, MBBS and Jennifer Perera, MD.
(2007). Chikungunya Viral Infections, An Emerging Problem. J Travel l^ed, 14, 320-325.
Thai, Khoa T. D., et al., (2005). Incidence of primary dengue virus infections in Southern Vietnamese children and reactivity against other flaviviruses. Tropical Medicine & International Heaiti) 12, 1553-1557.
